Weighing the costs of fertility treatments

Sondra Headrick is in the 27th week of a pregnancy perilous for herself and the six babies growing inside her. Her sextuplets resulted from the use of powerful drugs that stimulate the ovaries - the only fertility treatment Sondra and her husband, Eldon, could afford.

Doctors say the dangerous though rare outcome could have been avoided if the Headricks had had access to a more costly infertility treatment called in vitro fertilization, or IVF.

IVF allows doctors more control over how many babies a woman ends up carrying. But it costs about $8,000 a cycle, compared with $1,000 to $1,500 a cycle for fertility drugs.

And few health insurance plans cover IVF. Kansas is among 36 states that do not require insurers to offer some fertility coverage.

It's an issue more couples will face as a growing number seek treatment for infertility.

"The decisions we have to make are not driven by ends-based medicine," said David Grainger, a Wichita fertility specialist who treated the Headricks. "They're driven by the economics of what the patient can afford."

But insurance companies counter that they can't cover everything.

"Insurance started out as a way to fund catastrophic illnesses," said Jill Sumfest, chief medical officer of Preferred Health Systems, the Headricks' insurer. "That's evolved somewhat, but there are still questions: Is it the responsibility of a health plan that is normally treating an illness or an injury to also pay for fertility services? That's still a debatable point."

Multiples on the rise

The number of multiple births has risen as more people seek advanced fertility treatments. In 1980, before the treatments were widely available, 1,377 babies were born in pregnancies involving triplets or more nationwide. In 1999, 7,325 were born.

But triplets and larger sets of babies are 10 times more likely to die than single babies. They are usually born prematurely and face heightened risks for birth defects, including vision problems, digestive problems and cerebral palsy.

About one out of four women who conceive using high-strength fertility drugs will have twins or more. About 7 percent of those will be triplets or more, studies show.

Federal statistics show that pregnancies involving triplets or more have been as common among women who use IVF as those who use the kind of fertility drugs that Sondra Headrick used.

What those statistics don't show is how many of the triplet-and-more pregnancies involved four, five, six, seven or eight fetuses - and the danger to the mother and children rises dramatically at each of those steps.

In IVF, eggs and sperm are mixed in a laboratory, creating embryos to be inserted directly into a woman's uterus.